The origin of the popliteal cyst is the popliteal bursa and frequently combined with the intraarticular lesion. And open excision has been commonly used as a treatment. The authors reviewed 39 cases of popliteal cyst in 38 patients, mangaged with arthroscopic method at Department of Orthopedic Surgery, College of Medicine, Korea University Hospital from June 1989 to July 1993 and the following results were obtained. l. Among 39 cases, 35 cases(89.7%) were associated with intraarticular lesions of the knee joint; 25 cases(71.4%) were chondral injuries, 6 cases(17.1%) were meniscus tear, 2 cases(5.7%) were rheumatoid arthritis and 2 cases were plica syndrome. 2. 20 cases(51.2%) were shown to have the communication between cyst and joint. 3. During operation, position change of the patient and another draping was not necessary. And the blue stained wall enabled authors to remove more completely the popliteal cyst than other conventional operative procedures. 4. Becuase of the short skin incision, the operation time was saved and we were able to recommend early excercise of the knee joint and ambulation. The operative treatment of popliteal cyst with the arthroscopy is the one staged method to excise the cyst and to intervent the combined intraarticular pathology which develop the cyst, and is one of the recommendable method bacause of small skin incision, short hospitalization and early rehabilitation.
Arthritis, Rheumatoid ; Arthroscopy ; Hospitalization ; Humans ; Joints ; Knee Joint ; Korea ; Methods ; Orthopedics ; Pathology ; Popliteal Cyst ; Rehabilitation ; Skin ; Surgical Procedures, Operative ; Tears ; Walking

Scrotal calcinosis, consisting of solitary or multiple circumscribed calcium deposits within the dermis of the scrotum, is generally assumed to be one the idiopathic type of calcinosis. We present herein a case of serotal calcinosis associated with scrotal epidermal cysts in a 29-year-old male patient who had multiple, 2 to 6mm sized, yellowish or flesh colored nodules in the dermis, Histopathologically multiple ncdules showed intact epidermal cyzts, an epidermal cyst with a partialIy degenerated wall and surrounding foreign body reaction, and calcium deposits with foreign body reaction in the dermis without an epithelial lining around calcium deposit. Therefore, idiopathic scrotal calcinosis may repreeent the end stage of dystrophic calcificati.on associated with inflammation of the scrotal epidermal cysts.
Adult ; Calcinosis* ; Calcium ; Dermis ; Epidermal Cyst* ; Foreign-Body Reaction ; Humans ; Inflammation ; Male ; Scrotum

A 26-year-old female presented herself to our clinic due to noduloulcerative lesions of one month duration on her face and trunk with accompaning headache and mild fever. In family history, her husband was reported to have a history of chaner. On physical examinat.ion, rice sized eythematous papules and bean sized nodules with central ulceration were seen on the face and trunk. VDRL was 1:31 positive. A skin biopsy iif a noduloulcerative lesion showed ulceration, vascular dilatation with fibrinoid changes and perivascular inflarnmatory cellu infilt.rations, especially plasma cells. Immunoperoxidase stain showed T. pallidum at the epidermis and papillary dermis. The diagnsis was made asecondary syphilis with unusual clinical presentation as noduloucerative skin lesions. The skin lesions completely disappeared one month after treatment with injection of benzathine pelnicillin G 2.4 million unit intramuscularly weekly for three times.
Adult ; Biopsy ; Dermis ; Dilatation ; Epidermis ; Female ; Fever ; Headache ; Humans ; Plasma Cells ; Skin ; Spouses ; Syphilis* ; Ulcer

Lyme disease is an infecious disease caused by Borrelia burgdorfieii and has been reported world-wide. The spirochete invades multiple organs and induces manifesations in the skin, joints, neri us and cardiovascular systems. 13espite a considerable amount of serological evidence and isolation of R burgdorferi in ticks, no human case has yet been reported in korea. In this report, we present the first clinical case of Lyme disease in Korea. A female patient, 26 years old, developed clinical signs of eryth m,i chronicum migpans about ten days after traveling to a rural area and responded well to treatment ith entibiotions. Laboratory tests showed elevated IgM and IgG responses to B. burgdorferi, and a spirociete was found in a skin biopsy by electron microscopy.
Adult ; Biopsy ; Borrelia ; Borrelia burgdorferi ; Cardiovascular System ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Korea ; Lyme Disease* ; Microscopy, Electron ; Skin ; Spirochaetales ; Ticks

Lyme disease is a vector-borne infection, primarily transmitted by Ixodes ticks, and caused by Borrelia burgdorferi. It has a wide distribution in the northern hemisphere. In Korea, however, only one human case has been reported, although B. burgdorferi was isolated from the vector tick I. persulcatus in the region. A 60-year-old male and a 45-year-old female developed the clinical sign of erythema migrans. Each patients were bitten by a tick four weeks and five weeks, respectively, before entering the hospital. On serologic examination, significantly increased IgM and IgG antibody titers to B. burgdorferi were observed in consecutive tests performed at an interval of two weeks. They responded well to treatment with tetracycline.
Case Report ; Erythema Chronicum Migrans/pathology* ; Erythema Chronicum Migrans/immunology ; Erythema Chronicum Migrans/drug therapy ; Female ; Human ; Korea ; Lyme Disease/pathology* ; Lyme Disease/immunology ; Lyme Disease/drug therapy ; Male ; Middle Age

Dendritic cells (DC) are highly efficient antigen-presenting cells that initiate the primary immune response. Several laboratories have developed culture systems for human DC from peripheral blood monocytes. Most of these studies have used fetal calf serum (FCS) containing culture conditions that are inappropriate for human application. GM-CSF and IL-4 were used to make immature DC. The monocyte-conditioned medium (MCM) was used to induce the final maturation of DC. Using the previously described methods, the quality of MCM has unpredictable variations. Therefore using a defined cocktail of growth factors for the generation of mature DC would be advantageous for experimental as well as clinical purposes. In this study, it is suggested that combinations of both GM-CSF/IL-4 or GM-CSF/IL-13 could be used as the first-step culture to produce immature DC, and that cytokine cocktail (GM-CSF, IL-4, IL-1beta, TNF-alpha, IL-6, PGE2) was as efficient as MCM for the second step-culture to produce fully maturated DC. Here, we have generated an easily reproducible culture system for DC that allows for the generation of large amounts of immature and mature DC, and we also now have established the method in a FCS-free system that is suitable for clinical use.
Cell Division/drug effects ; Culture Media/pharmacology ; Cytokines/pharmacology ; Cytological Techniques* ; Dendritic Cells/cytology* ; Human ; Monocytes/cytology*

PURPOSE: Central pancreatectomy (CP) may be indicated for the treatment of benign or low-grade malignant tumor in the neck and proximal body of the pancreas. Pancreatic fistula is one of the most common complications after CP. In this study, we suggested an inverted mattress pancreaticojejunostomy (IM-PJ) technique to decrease the risk of pancreatic fistula. METHODS: Between 2010 and 2015, CP was performed with IM-PJ for 10 consecutive patients with a benign or low-grade malignant tumor in the neck and proximal body of the pancreas. All clinical and pathological data were analyzed retrospectively. RESULTS: Median age was 56.4 years (range, 17–75 years). Median surgery duration was 286 minutes (range, 205–410 minutes). In all cases, the distal stump was reconstructed using the IM-PJ method. Median duration of hospital stay was 23.8 days (range, 9–53 days). No patient mortality occurred. Pancreatic fistula developed in 9 cases (90%); however, all fistulas were grade A and resolved without surgical or radiological intervention. Nine patients remain well with no recurrence or new endocrine or exocrine dysfunction. CONCLUSION: Our results demonstrate that the outcomes of CP with IM-PJ are reasonable for prevention of pancreatic fistula following CP.
Fistula ; Humans ; Length of Stay ; Methods ; Mortality ; Neck ; Pancreas ; Pancreatectomy* ; Pancreatic Fistula* ; Pancreaticojejunostomy* ; Recurrence ; Retrospective Studies

BACKGROUND: Cadherins are a supergene family of structurally related transmembrane glycoprotein. V-cadherin was a subclass of cadherin which expressed on endothelial cell as an endothelial cell cell adhesion molecule. The role of V-cadherin is still unclear in inflarnmation and immunologic responses. OBJECTIVE: Our purpose was to demonstrate the expression and the regulation of V-cadherin expression on human dermal microvascular endothelial cells(HDMEC) by biological response modifier(BRM). METHODS: The cell surface expression of V-cadherin on HDMEC that was unstimulated or pretreated with IL-1, TNF, IFN-, and PMA was evaluated by immunofluorescence flow cytometry and the enzyme-linked immunosorbent assay. RESULTS: 1. V-cadherin was constitutively expressed on unstimulated HDMEC. 2. Maximal expression of V-cadherin was observed at 16 hrs after stimulation with IL-1, at 6 hrs after stimulation with TNF and at 24 hrs after stimulation with IFN- on HDMEC. 3. V-cadherin expression on HDMEC was increased after stimulation with IL-1 or PMA. CONCLUSION: V-cadherin was constitutively expressed on HDMEC, and V-cadherin expression can be regulated by BRM. These results suggest V-cadherin may contribute to inflammation.
Cadherins ; Cell Adhesion ; Endothelial Cells* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Fluorescent Antibody Technique ; Glycoproteins ; Humans* ; Inflammation ; Interleukin-1

PURPOSE: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. MATERIALS AND METHODS: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c < 6.0% and fasting glucose level < 110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR < 1.35), 2Q (n=82; 1.35≤HOMA-IR < 1.93), 3Q (n=83; 1.93≤HOMA-IR < 2.73), and 4Q (n=83; HOMA-IR≥2.73). RESULTS: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79–7.03, p < 0.001) and 2.12 (95% CI: 1.07–4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. CONCLUSION: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.
Acetylcholine ; Blood Glucose ; Body Mass Index ; Chest Pain ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels* ; Diabetes Mellitus ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Nitroglycerin ; Spasm* ; Triglycerides

No abstract available.
Goiter* ; Humans ; Siblings*